Category Archives: Management of Patients with Orafacial Clefts

Prosthetic Speech Aid Appliances
Prosthetic care for the cleft patient mav be Il\?ce~\ar~ Ior wo reasons: first, teeth that are so frequently Illi~sing in the cleft-afflicted patient should be replaced. Second. in patients who have failed to obtain velopharyngeal competence with SUrgical corrections. a speech aid appliance can be made by the dentist to decrease hypernasal speech. A speech aid appliance is an

DENTAL NEEDS OF CLEFT AFLFLlCTED INDIVIDUALS
Dentists will have. cleft-afflicted patients in their practice because of the relatively large number of people so affected. These patients should not pose any great problems, because their dental needs do not differ dramatically
from those of other individuals. However, because of the presence of the cleft, either corrected or uncorrected, these individuals have a

Correction of Maxillomandibular Disharmonies
The individual with a cleft deformity will usually exhibit maxillarv retrusion and’ a transverse maxillary constriction resulting from the cicatricial contraction of previous’ surgeries. In many instances the associated alocclusion is beyond the scope of orthodontic treatment alone.,In
these cases orthognathic surgery similar ·to the procedures outlined

Alveolar Cleft Grafts
The alveolar cleft defect is usually not corrected in the original surgical correction of either the cleft lip or the cleft palate (Fig. 27-15 on pages 6..U-6-12). As a result, the cleft-afflicted individual may have residual oronasal fistulae in this area, and the maxillary alveolus will not be continuous because of the cleft. Because of this, five problems commonly occur: (1) oral flui

Palatorrhaphy
Palatorrhaphy Is usually performed in ope operation, but occasionally it is performed in two. In two operations the oft palate closure (i.e., staphylorrhaphy) is usually performed first and the hard palate closure (i.e., uranorrhaphy) is performed second. ()/Jjntin’s. The primary purpose. of the cleft palate repair is to create a mechanism capable of speech and deglutition without signif

Chellorrhaphy
Clieilorrhuphv is the surgical correction of the cleft lip deformity; this term is derived from junction by a seam or suture. It is usually the earliest
operative procedure used to correct cleft deformities and is undertaken as soon as medically possible. The cleft of the upper lip disrupts the important circumoral orbicularis oris musculature. The lack of continuity of this muscle allows th

Timing of Surgical Repair
The.timklg of the Surgical repair has been and remains one Of the most debated issues among surgeons, speech pathologists, audiologists, and orthodontists. It is tempting to correct all of the defcct-, as ~OOJ1 as the baby is able to withstand the surgical procedure. The parents of a child born with a facial cleft would certainlv desire this mode of treatment, eliminating all of the

TREATMENT OF CLEFT LIP AND PLATE
The aim of treatment of cleft lip and palate is to correct the cleft and associated problems surgically and thus hide the anomaly so that patients can lead normal lives. This correction involves surgically producing a face that does not attract attention, a vocal apparatus that permits intelligible. – speech, and a dentition that allows optimal function and esthetics. Op

Associated Anomalies
Although the child with an oral cleft is 20 times more likely to have another congenital anomaly than a normal child, no correlation is evident with specific anatomic zones of additional anomaly in volvernent Of those children who have associated anomalies, 38% have isolated cleft palate and 21% have cleft lip, with or without cleft palate. In the overall cleft-afflicted population, app